子宫恶性肿瘤术前MRI检查价值.docVIP

子宫恶性肿瘤术前MRI检查价值【摘要】目的 探讨MRI检查在子宫内膜癌和子宫颈癌中的诊断及术前分期中的应用价值。方法 回顾分析2004年1月至2010年1月在我院经病理证实为子宫内膜癌和子宫颈癌的患者各60例进行定量及定性分析,子宫颈癌患者中30例术前行MRI检查,另30例未行MRI检查。MRI检查应用Philips Achieva 1.5T超导型双梯度磁共振仪,采用体部线圈,常规行轴位T1WI(SE),T2WI(TSE),矢状T2WI(TSE)及T2WI脂肪抑制序列,层厚为4～5mm、层间距1mm。成像范围:轴位自双侧髂骨翼上缘至耻骨联合下缘,矢状位根据病变部位及范围而定。结果 子宫内膜癌患者中,MRI检查组:其判断分期的准确性是83.3%(25/30);对肿瘤局限于内膜、浸润浅肌层和浸润深肌层的敏感性分别为75.0%、82.4%和88.9%;特异性分别为96.2%、84.6%和90.5%;准确性分别为93.3%、83.3%和90.0%;阳性预测值分别为75.0%、87.5%和80.0%;阴性预测值分别为96.2%、78.6%和95.0%。非MRI检查组中,其判断分期的准确性是66.7%(20/30)。宫颈癌患者中,MRI检查组:判断分期的准确性是80.0%(24/30);判断宫旁浸润的准确性、特异性、敏感性、阳性预测值和阴性预测值分别为93.3%、96.2%、75.0%、75.0%和96.2%。非MRI检查组:术前临床分期的准确性是66.7%(20/30);判断宫旁浸润的准确率、特异性、敏感性、阳性预测值、阴性预测值分别为86.7%、92.6%、33.3%、33.3%和92.6%。结论 1.MRI对术前子宫内膜癌,尤其是对肌层浸润深度方面的准确分期具有很高价值。2. MRI清楚显示癌灶大小、位置及宫旁浸润,对术前宫颈癌分期明显优于临床分期。 【关键词】子宫恶性肿瘤磁共振成像(MRI)肿瘤分期浸润深度 【中图分类号】R737.3 【文献标识码】A 【文章编号】1004-7484(2010)08-00-03 Value of mri in preoperative assessment of uterine tumors 【Abstract】Objective To explore the value of MRI in diagnosis and preoperative staging of endometrial carcinoma and cervical cancer, to analyze and summarize the different stagings of the MRI findings of the common m alignant uterine tumor, guide the MRI examination in the field of gynecology application. Methods To quantitative and qualitative analysis of the data of 60 cases of various were pathologically confirmed endometrial carcinoma and cervical cancer in our hospital between Jan.2004 and Jan.2010. Similarly, 30 patients with cervical cancer underwent MRI scan before operation, another 30 patients were not underwent MRI. All general information were comparable, who were not underwent MRI were selected on randomly over the same period and all performed operation, then compared the preoperative MRI stagings and clinical stagings with the operation-pathologic stagings, separatly. MRI with body coils of Philips Achieva 1.5T. The patients laid on back and were performed by axial(spin echo): T1WI, T2WI; saggital(tubor spin echo): T2WI and fat-sat